IDEA4RC FHIR Implementation Guide, published by IDEA4RC Project. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7-eu/idea4rc/ and changes regularly. See the Directory of published versions

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• Detailed Descriptions
• Mappings
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• XML
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Resource Profile: Observation: TNM Regional Nodes Category

Category of the presence or absence of metastases in regional lymph nodes, based on evidence such as physical examination, imaging, and/or biopsy.

Usage:

• Refer to this Resource Profile: Observation: Head Neck Cancer Stage Group
• Examples for this Resource Profile: Observation/observation-id-0 and Observation/observation-id-3

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

• Key Elements Table
• Differential Table
• Snapshot Table
• Statistics/References
• All

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	Observation	Measurements and simple assertions dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
status	?!Σ	1..1	code	The status of the result Binding: ObservationStatus (required): Codes providing the status of an observation. ele-1: All FHIR elements must have a @value or children
code	Σ	1..1	CodeableConcept	What was observed Binding: Observation Codes for Regional Node Category (required) ele-1: All FHIR elements must have a @value or children
subject	Σ	1..1	Reference(Patient: IDEA4RC)	Who and/or what the observation is about ele-1: All FHIR elements must have a @value or children
focus	Σ	0..*	Reference(Condition: Primary Cancer)	What the observation is about, when it is not about the subject of record ele-1: All FHIR elements must have a @value or children
effective[x]	Σ	0..1		Clinically relevant time for observation ele-1: All FHIR elements must have a @value or children
effectiveDateTime			dateTime
effectivePeriod			Period
effectiveTiming			Timing
effectiveInstant			instant
value[x]	ΣC	0..1	CodeableConcept	Actual result. Binding: TNM Regional Nodes Category Value Set (example) Additional Bindings Purpose Pathological T Preferred ele-1: All FHIR elements must have a @value or children
method		0..1	CodeableConcept	ADD BINDING Binding: ObservationMethods (example): Methods for simple observations. ele-1: All FHIR elements must have a @value or children
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Observation.status	required	ObservationStatus http://hl7.org/fhir/ValueSet/observation-status|4.0.1 from the FHIR Standard
Observation.code	required	ObservationCodesRegionalNodesVS http://hl7.eu/fhir/ig/idea4rc/ValueSet/mcode-observation-codes-regional-nodes-vs from this IG
Observation.value[x]	example	TNMRegionalNodesCategoryVS http://hl7.eu/fhir/ig/idea4rc/ValueSet/mcode-tnm-regional-nodes-category-vs from this IG
Observation.method	example	ObservationMethods http://hl7.org/fhir/ValueSet/observation-methods from the FHIR Standard
Observation.component.code	example	LOINCCodes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard

This structure is derived from Observation

Name	Flags	Card.	Type	Description & Constraints
Observation			Observation
status		1..1	code	The status of the result
code		1..1	CodeableConcept	What was observed Binding: Observation Codes for Regional Node Category (required)
subject		1..1	Reference(Patient: IDEA4RC)	Who and/or what the observation is about
focus		0..*	Reference(Condition: Primary Cancer)	What the observation is about, when it is not about the subject of record
effective[x]		0..1	dateTime, Period, Timing, instant	Clinically relevant time for observation
value[x]		0..1	CodeableConcept	Actual result. Binding: TNM Regional Nodes Category Value Set (example) Additional Bindings Purpose Pathological T Preferred Pathological T Preferred
method		0..1	CodeableConcept	ADD BINDING
device		0..0
referenceRange		0..0
hasMember		0..0
component		0..0
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Observation.code	required	ObservationCodesRegionalNodesVS http://hl7.eu/fhir/ig/idea4rc/ValueSet/mcode-observation-codes-regional-nodes-vs from this IG
Observation.value[x]	example	TNMRegionalNodesCategoryVS http://hl7.eu/fhir/ig/idea4rc/ValueSet/mcode-tnm-regional-nodes-category-vs from this IG

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	Observation	Measurements and simple assertions obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Business Identifier for observation
basedOn	Σ	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	Fulfills plan, proposal or order
partOf	Σ	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)	Part of referenced event
status	?!Σ	1..1	code	The status of the result Binding: ObservationStatus (required): Codes providing the status of an observation.
category		0..*	CodeableConcept	Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
code	Σ	1..1	CodeableConcept	What was observed Binding: Observation Codes for Regional Node Category (required)
subject	Σ	1..1	Reference(Patient: IDEA4RC)	Who and/or what the observation is about
focus	Σ	0..*	Reference(Condition: Primary Cancer)	What the observation is about, when it is not about the subject of record
encounter	Σ	0..1	Reference(Encounter)	Healthcare event during which this observation is made
effective[x]	Σ	0..1		Clinically relevant time for observation
effectiveDateTime			dateTime
effectivePeriod			Period
effectiveTiming			Timing
effectiveInstant			instant
issued	Σ	0..1	instant	Date/Time this version was made available
performer	Σ	0..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)	Who is responsible for the observation
value[x]	ΣC	0..1	CodeableConcept	Actual result. Binding: TNM Regional Nodes Category Value Set (example) Additional Bindings Purpose Pathological T Preferred
dataAbsentReason	C	0..1	CodeableConcept	Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
note		0..*	Annotation	Comments about the observation
bodySite		0..1	CodeableConcept	Observed body part Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
method		0..1	CodeableConcept	ADD BINDING Binding: ObservationMethods (example): Methods for simple observations.
specimen		0..1	Reference(Specimen)	Specimen used for this observation
derivedFrom	Σ	0..*	Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence)	Related measurements the observation is made from
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Observation.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages from the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
Observation.status	required	ObservationStatus http://hl7.org/fhir/ValueSet/observation-status|4.0.1 from the FHIR Standard
Observation.category	preferred	ObservationCategoryCodes http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.code	required	ObservationCodesRegionalNodesVS http://hl7.eu/fhir/ig/idea4rc/ValueSet/mcode-observation-codes-regional-nodes-vs from this IG
Observation.value[x]	example	TNMRegionalNodesCategoryVS http://hl7.eu/fhir/ig/idea4rc/ValueSet/mcode-tnm-regional-nodes-category-vs from this IG
Observation.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.interpretation	extensible	ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard
Observation.bodySite	example	SNOMEDCTBodyStructures http://hl7.org/fhir/ValueSet/body-site from the FHIR Standard
Observation.method	example	ObservationMethods http://hl7.org/fhir/ValueSet/observation-methods from the FHIR Standard
Observation.referenceRange.type	preferred	ObservationReferenceRangeMeaningCodes http://hl7.org/fhir/ValueSet/referencerange-meaning from the FHIR Standard
Observation.referenceRange.appliesTo	example	ObservationReferenceRangeAppliesToCodes http://hl7.org/fhir/ValueSet/referencerange-appliesto from the FHIR Standard
Observation.component.code	example	LOINCCodes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.component.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.component.interpretation	extensible	ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard

This structure is derived from Observation

Summary

Mandatory: 1 element
Prohibited: 4 elements

Structures

This structure refers to these other structures:

• Patient: IDEA4RC (http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/patient-eu-i4rc)
• Condition: Primary Cancer (http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/Condition-primaryCancer-eu-i4rc)

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	Observation	Measurements and simple assertions dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
status	?!Σ	1..1	code	The status of the result Binding: ObservationStatus (required): Codes providing the status of an observation. ele-1: All FHIR elements must have a @value or children
code	Σ	1..1	CodeableConcept	What was observed Binding: Observation Codes for Regional Node Category (required) ele-1: All FHIR elements must have a @value or children
subject	Σ	1..1	Reference(Patient: IDEA4RC)	Who and/or what the observation is about ele-1: All FHIR elements must have a @value or children
focus	Σ	0..*	Reference(Condition: Primary Cancer)	What the observation is about, when it is not about the subject of record ele-1: All FHIR elements must have a @value or children
effective[x]	Σ	0..1		Clinically relevant time for observation ele-1: All FHIR elements must have a @value or children
effectiveDateTime			dateTime
effectivePeriod			Period
effectiveTiming			Timing
effectiveInstant			instant
value[x]	ΣC	0..1	CodeableConcept	Actual result. Binding: TNM Regional Nodes Category Value Set (example) Additional Bindings Purpose Pathological T Preferred ele-1: All FHIR elements must have a @value or children
method		0..1	CodeableConcept	ADD BINDING Binding: ObservationMethods (example): Methods for simple observations. ele-1: All FHIR elements must have a @value or children
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Observation.status	required	ObservationStatus http://hl7.org/fhir/ValueSet/observation-status|4.0.1 from the FHIR Standard
Observation.code	required	ObservationCodesRegionalNodesVS http://hl7.eu/fhir/ig/idea4rc/ValueSet/mcode-observation-codes-regional-nodes-vs from this IG
Observation.value[x]	example	TNMRegionalNodesCategoryVS http://hl7.eu/fhir/ig/idea4rc/ValueSet/mcode-tnm-regional-nodes-category-vs from this IG
Observation.method	example	ObservationMethods http://hl7.org/fhir/ValueSet/observation-methods from the FHIR Standard
Observation.component.code	example	LOINCCodes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard

Differential View

This structure is derived from Observation

Name	Flags	Card.	Type	Description & Constraints
Observation			Observation
status		1..1	code	The status of the result
code		1..1	CodeableConcept	What was observed Binding: Observation Codes for Regional Node Category (required)
subject		1..1	Reference(Patient: IDEA4RC)	Who and/or what the observation is about
focus		0..*	Reference(Condition: Primary Cancer)	What the observation is about, when it is not about the subject of record
effective[x]		0..1	dateTime, Period, Timing, instant	Clinically relevant time for observation
value[x]		0..1	CodeableConcept	Actual result. Binding: TNM Regional Nodes Category Value Set (example) Additional Bindings Purpose Pathological T Preferred Pathological T Preferred
method		0..1	CodeableConcept	ADD BINDING
device		0..0
referenceRange		0..0
hasMember		0..0
component		0..0
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Observation.code	required	ObservationCodesRegionalNodesVS http://hl7.eu/fhir/ig/idea4rc/ValueSet/mcode-observation-codes-regional-nodes-vs from this IG
Observation.value[x]	example	TNMRegionalNodesCategoryVS http://hl7.eu/fhir/ig/idea4rc/ValueSet/mcode-tnm-regional-nodes-category-vs from this IG

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	Observation	Measurements and simple assertions obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Business Identifier for observation
basedOn	Σ	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	Fulfills plan, proposal or order
partOf	Σ	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)	Part of referenced event
status	?!Σ	1..1	code	The status of the result Binding: ObservationStatus (required): Codes providing the status of an observation.
category		0..*	CodeableConcept	Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
code	Σ	1..1	CodeableConcept	What was observed Binding: Observation Codes for Regional Node Category (required)
subject	Σ	1..1	Reference(Patient: IDEA4RC)	Who and/or what the observation is about
focus	Σ	0..*	Reference(Condition: Primary Cancer)	What the observation is about, when it is not about the subject of record
encounter	Σ	0..1	Reference(Encounter)	Healthcare event during which this observation is made
effective[x]	Σ	0..1		Clinically relevant time for observation
effectiveDateTime			dateTime
effectivePeriod			Period
effectiveTiming			Timing
effectiveInstant			instant
issued	Σ	0..1	instant	Date/Time this version was made available
performer	Σ	0..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)	Who is responsible for the observation
value[x]	ΣC	0..1	CodeableConcept	Actual result. Binding: TNM Regional Nodes Category Value Set (example) Additional Bindings Purpose Pathological T Preferred
dataAbsentReason	C	0..1	CodeableConcept	Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
note		0..*	Annotation	Comments about the observation
bodySite		0..1	CodeableConcept	Observed body part Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
method		0..1	CodeableConcept	ADD BINDING Binding: ObservationMethods (example): Methods for simple observations.
specimen		0..1	Reference(Specimen)	Specimen used for this observation
derivedFrom	Σ	0..*	Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence)	Related measurements the observation is made from
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Observation.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages from the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
Observation.status	required	ObservationStatus http://hl7.org/fhir/ValueSet/observation-status|4.0.1 from the FHIR Standard
Observation.category	preferred	ObservationCategoryCodes http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.code	required	ObservationCodesRegionalNodesVS http://hl7.eu/fhir/ig/idea4rc/ValueSet/mcode-observation-codes-regional-nodes-vs from this IG
Observation.value[x]	example	TNMRegionalNodesCategoryVS http://hl7.eu/fhir/ig/idea4rc/ValueSet/mcode-tnm-regional-nodes-category-vs from this IG
Observation.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.interpretation	extensible	ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard
Observation.bodySite	example	SNOMEDCTBodyStructures http://hl7.org/fhir/ValueSet/body-site from the FHIR Standard
Observation.method	example	ObservationMethods http://hl7.org/fhir/ValueSet/observation-methods from the FHIR Standard
Observation.referenceRange.type	preferred	ObservationReferenceRangeMeaningCodes http://hl7.org/fhir/ValueSet/referencerange-meaning from the FHIR Standard
Observation.referenceRange.appliesTo	example	ObservationReferenceRangeAppliesToCodes http://hl7.org/fhir/ValueSet/referencerange-appliesto from the FHIR Standard
Observation.component.code	example	LOINCCodes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.component.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.component.interpretation	extensible	ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard

This structure is derived from Observation

Summary

Mandatory: 1 element
Prohibited: 4 elements

Structures

This structure refers to these other structures:

• Patient: IDEA4RC (http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/patient-eu-i4rc)
• Condition: Primary Cancer (http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/Condition-primaryCancer-eu-i4rc)

Other representations of profile: CSV, Excel, Schematron